title: The relevance of iron overload and the appropriateness of iron chelation therapy for patients with myelodysplastic syndromes: a dialogue and debate.
abstract: Accumulation of excessive amounts of iron in vulnerable organs and tissues, together with elevated plasma and intracellular concentrations of reactive iron molecules, are likely to be harmful to some patients with myelodysplastic syndromes (MDS) who have received numerous red blood cell transfusions. But what is the real magnitude of risks related to iron overload in MDS, and how strong is the evidence that reducing total body iron and labile plasma iron through treatment with chelating drugs is beneficial to patients? Available data can be interpreted in different ways, and as a result, these topics continue to be areas of heated debate among physicians who care for patients with MDS. Using the traditional but rarely employed format of a classical dialogue, I explore here the potential dangers of iron overload and the risks and benefits of iron chelation therapy for patients with MDS.
authors.affiliation: Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Suite D1B30 (Mayer 1B21), Boston, MA 02215, USA. david_steensma@dfci.harvard.edu
authors.forename: David P
authors.initials: DP
authors.lastname: Steensma
mesh_terms: D015913:Chelation Therapy / Q000379:methods*; D017707:Erythrocyte Transfusion; D006801:Humans; D007502:Iron Chelating Agents / Q000627:therapeutic use*; D019190:Iron Overload / Q000097:blood / Q000188:drug therapy*; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000628:therapy*; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D007502:Iron Chelating Agents